Background: Most people die of non-malignant disease, but most patients of specialist palliative care services havecancer. Adequate end of life care for people with non-malignant disease requires acknowledgement of their limitedprognosis and appropriate care planning. Case conferences between specialist palliative care services and GPsimprove outcomes in cancer-based populations. We report a pilot study of case conferences between the patient’sGP and specialist staff to facilitate care planning for people with end stage heart failure or non-malignant lungdisease in a regional health service in Queensland Australia.Methods: Single face to face case conferences about patients with a primary diagnosis of advanced heart failureor respiratory failure from non-malignant disease were conducted between a palliative care consultant, a casemanagement nurse and the patient’s GP. Annualised rates of service utilisation (emergency department [ED]presentations, ED discharges back to home, hospital admissions, and admission length of stay) before and after caseconference were calculated. Content and counts of case conference recommendations, and the rate of adherenceto recommendations were also assessed. A process evaluation of case conferences was undertaken.Results: Twenty-three case conferences involving 21 GPs were conducted between November 2011 and November2012. One GP refused to participate. Ten patients died, three at home. Of 82 management recommendations made,55 (67%) were enacted. ED admissions fell from 13.9 per annum (pa) to 2.1 (difference 11.8, 95% CI 2.2-21.3,p = 0.001); ED admissions leading to discharge home from 3.9 to 0.4 pa (difference 3.5, 95% CI -0.4-7.5, p = 0.05);hospital admissions from 11.4 to 3.5 pa (difference 7.9, 95% CI 2.2-13.7, p = 0.002); and length of stay from 7.0to 3.7 days (difference 3.4, 95% CI 0.9-5.8, p = 0.007). Participating health professionals were enthusiastic aboutthe process.Conclusions: This pilot is the initial step in the development and testing of a complex intervention based on amodel of integrated care. A single case conference involving the patient’s heart or lung failure team is associatedwith significant reductions in service utilization, apparently by improving case coordination, enhancing symptommanagement and assessing and managing carer needs. A randomized controlled trial is being developed.